What You Really Need to Know About Small Intestinal Bacterial Overgrowth If you’re experiencing daily bloating, gas, abdominal pain, or unpredictable bowel habits, you’re not alone—and it’s not "just IBS." One increasingly recognized cause of digestive distress is Small Intestinal Bacterial Overgrowth (SIBO) , a condition where excessive or misplaced bacteria colonize the small intestine. This overgrowth disrupts normal digestion and absorption, often mimicking or overlapping with other gut disorders like IBS, acid reflux, or food sensitivities. But with the rise in popularity of the term “SIBO” has come an increase in myths and misinformation. Let’s separate fact from fiction—using current evidence-based data—so you can better understand what’s happening in your gut and how to begin your journey toward lasting relief. Myth 1: SIBO Is Rare Truth: It’s more common than most people realize, especially in those diagnosed with IBS. A meta-analysis published in Gut and Liver found that up to 78% of IBS patients tested positive for SIBO using hydrogen and methane breath tests (1). Many people living with "IBS" may be managing symptoms without addressing the root cause. In my Toronto practice, I regularly see patients who have struggled with digestive symptoms and on and off various diets for years before discovering they were dealing with undiagnosed SIBO. Myth 2: SIBO Is an Infection Caused by “Bad Bacteria.” Truth: It’s not about what bacteria are present—it’s about where they are. The small intestine typically contains relatively few microbes compared to the colon. In SIBO, the bacteria are often normal commensals that have migrated from the large intestine to the small intestine, where they ferment carbohydrates too early in the digestive process. This fermentation produces gases like hydrogen, methane, or hydrogen sulphide, which cause bloating, distension, and altered bowel movements. That’s why simply killing bacteria with antibiotics or herbal antimicrobials is often not enough. The underlying issue is a breakdown in the body’s gut defence mechanisms. Myth 3: Antibiotics or Diet Alone Will Cure SIBO Truth: While prescription antibiotics (like rifaximin) or herbal antimicrobials (such as berberine, neem, or oregano oil) can reduce bacterial load, long-term resolution requires a comprehensive, individualized strategy. Evidence suggests that recurrence rates of SIBO are high (up to 45% within 9 months [2]), especially if underlying causes aren't addressed. An effective treatment plan typically includes: • Biofilm disruptors to weaken bacterial resistance • Motility agents to improve intestinal clearance (MMC support) • Digestive support (enzymes, bile acids, stomach acid) • Dietary guidance (such as low-FODMAP, SIBO-specific diets) • Stress and nervous system support • Careful use of probiotics (often spore-based or yeast-derived) Myth 4: Everyone with SIBO Should Take Probiotics Truth: Not all probiotics are helpful in SIBO, and some can make symptoms worse. While certain strains of probiotics have been shown to improve SIBO treatment and recurrence, some studies suggest that traditional lactobacillus-based probiotics can exacerbate symptoms in some cases (3). That’s because these strains may further contribute to fermentation in an already overpopulated small intestine. In contrast, Bacillus Coagulans (and/or other soil-based probiotics) or Saccharomyces boulardii (a beneficial yeast) may provide symptom relief in select cases without contributing to overgrowth. Myth 5: SIBO Happens Without a Reason Truth: SIBO is a symptom of an underlying dysfunction in the gastrointestinal system. To truly resolve and prevent recurrence, we must uncover what created the environment for overgrowth in the first place. Contributing factors can include: • Low stomach acid or pancreatic enzyme insufficiency • Impaired motility, especially the Migrating Motor Complex (MMC) • Bile insufficiency or gallbladder dysfunction • Structural issues (e.g., adhesions or ileocecal valve dysfunction) • Nerve or vagus dysfunction • Chronic stress • History of food poisoning, antibiotic use, or abdominal surgery This is where functional digestive testing (including breath testing and stool analysis) can guide targeted, root-cause interventions. Healing SIBO: An Individualized Approach In my practice, not only do I offer SIBO breath testing (including both hydrogen and methane gas analysis) and treatment, but a fully individualized treatment approach that considers the why, not just the what. Stool testing and other diagnostics are also always considered as part of the assessment, as many other concerns like hydrogen sulphide bacteria and visceral hypersensitivity can also mirror SIBO. If you're tired of living with bloating, discomfort, and unreliable digestion, there is a path forward. With the right testing, personalized protocols, and holistic support, SIBO can be effectively managed and often resolved. Ready to get to the root of your symptoms and feel like yourself again? Book a personalized consultation with Dr. Courtney Holmberg , ND — a leading Naturopathic Doctor in Toronto with a clinical focus on gut and hormonal health. 📅 Schedule your appointment online or call (647) 351-7282 to get started today. References: Tansel A, Levinthal DJ. Understanding Our Tests: Hydrogen-Methane Breath Testing to Diagnose Small Intestinal Bacterial Overgrowth. Clin Transl Gastroenterol. 2023 Apr 1;14(4):e00567. doi: 10.14309/ctg.0000000000000567. PMID: 36744854; PMCID: PMC10132719. •Lauritano, Ernesto C. M.D.1; Gabrielli, Maurizio Ph.D.1; Scarpellini, Emidio M.D.1; Lupascu, Andrea M.D.1; Novi, Marialuisa M.D.1; Sottili, Sandra Ph.D.2; Vitale, Giovanna M.D.1; Cesario, Valentina M.D.1; Serricchio, Michele M.D.1; Cammarota, Giovanni M.D.1; Gasbarrini, Giovanni M.D.1; Gasbarrini, Antonio M.D.1. Small Intestinal Bacterial Overgrowth Recurrence After Antibiotic Therapy. American Journal of Gastroenterology 103(8): p 2031-2035, August 2008. Chen WC, Quigley EM. Probiotics, prebiotics & synbiotics in small intestinal bacterial overgrowth: opening up a new therapeutic horizon! Indian J Med Res. 2014 Nov;140(5):582-4. PMID: 25579137; PMCID: PMC4311309.

If you flush after wine, get random headaches, wake with congestion you can’t explain, or feel reactive to “healthy” fermented foods, histamine intolerance (HIT) may be on your radar. Histamine is a powerful signalling molecule involved in immune defence, digestion (especially gastric acid secretion), neurotransmission, and vascular tone. Problems arise when histamine builds up faster than your body can break it down—often due to low diamine oxidase (DAO) activity, gut barrier disruption, nutrient insufficiencies, environmental triggers, medication effects, or imbalances in the gut microbiome that produce or fail to clear histamine. Here’s the hopeful part: emerging research and clinical experience suggest that targeted probiotic strategies—along with dietary and lifestyle support—may help rebalance histamine metabolism, calm reactivity, and rebuild food tolerance over time. This article walks you through the science we have (and don’t yet have), how to choose low-histamine or histamine-lowering probiotic strains, how to introduce them safely, and how to integrate them into a broader root-cause naturopathic care plan. If you searched “probiotics for histamine intolerance,” you’re in the right place. Bookmark this page for strain-by-strain guidance, diet tips, and when to consider DAO support. Table of Contents Histamine Intolerance 101 Where Does Excess Histamine Come From? Common Symptoms & Patterns How Is Histamine Intolerance Assessed? Gut Microbiome & Histamine: Why Probiotics Matter Probiotics for Histamine Intolerance: What We Know How to Introduce Probiotics When You’re Reactive Low-Histamine Diet: Reset, Not Forever Supporting DAO & Gut Integrity Histamine Intolerance Treatment Approach FAQs: Probiotics & Histamine Intolerance Histamine Intolerance 101 Histamine intolerance (HIT) isn’t an allergy—it’s a load issue. When total histamine exposure (from food, gut bacteria, and endogenous immune release) exceeds your body’s ability to break it down, symptoms appear. The primary histamine-degrading enzyme in the gut is diamine oxidase (DAO). When DAO is low, overwhelmed, or inhibited, histamine accumulates, moves across the gut barrier, and circulates systemically. Fast facts HIT prevalence is uncertain; estimates range from <1% to several percent, but underdiagnosis is likely. Symptoms are multi-system: gut, skin, respiratory, neurological, cardiovascular, and hormonal. Histamine load is cumulative: a borderline meal may be fine on a low-symptom day but trigger a flare when combined with stress, alcohol, or seasonal allergies. Where Does Excess Histamine Come From? Excess histamine burden typically arises from one or more of the following contributors: Source Mechanism Example Triggers Dietary histamine Direct intake from aged, fermented, leftover, canned, smoked, or processed foods Wine, sauerkraut, aged cheese, cured meats, fish not frozen on catch Histamine-releasing foods Trigger mast cells to release histamine (not necessarily high in it) Citrus, strawberries, chocolate (variable) DAO blockers Reduce your ability to degrade histamine Alcohol, some energy drinks, black/green tea (individual) Low DAO production Genetic variants (AOC1 gene), intestinal damage, nutrient gaps Celiac, IBD, SIBO, and chemotherapy effects Histamine-producing gut bacteria Some species produce histamine or other biogenic amines Overgrowth states: dysbiosis Medications Some suppress DAO or trigger histamine release Certain NSAIDs, antibiotics, and muscle relaxants (drug-specific) Common Symptoms & Patterns Histamine intolerance is highly individual. Look for clustered, multi-system symptoms that flare with high-histamine meals, alcohol, stress, or hormone shifts. Digestive:  bloating, abdominal pain, diarrhea, nausea, reflux. Skin:  flushing, itching, hives, eczema flares. Respiratory/ENT:  runny or congested nose, sneezing, itchy eyes, throat tightness. Neurological:  headaches, migraines, dizziness, “hangover” feeling after eating or drinking. Cardiovascular:  palpitations, blood pressure swings. Hormonal & Cycle-Related:  PMS intensification, menstrual migraines. Anxiety-like Flares:  restlessness, irritability, wired-but-tired after meals. Pattern clue:  Symptoms that vary day to day, worsen with leftovers/restaurant meals/alcohol, and improve on a short low-histamine diet trial often warrant further evaluation. How Is Histamine Intolerance Assessed? There’s no single gold-standard lab. Diagnosis is clinical—based on history, symptom tracking, response to a structured low-histamine elimination and reintroduction, and ruling out mimicking conditions (IgE food allergy, celiac, IBD, chronic infections, MCAS, SIBO, mould exposure, etc.). Supporting tools may include: Serum DAO activity:  Low values may correlate with symptom severity in some patients, but normal values don’t rule HIT out. Lab variability is common. Symptom/food journals:  Track triggers, timing, and cumulative load. Targeted functional testing:  SIBO breath testing, stool microbiome (strain-level if possible), intestinal permeability & inflammation markers, nutrient status (B6, copper, zinc—cofactors for DAO activity). Trial of low-histamine diet  (typically 2–4 weeks) followed by structured reintroduction. Therapeutic trial of DAO enzyme  with higher-risk meals to see if symptoms improve. Clinical pearl:  DAO levels tend to track with response to treatment more than with strict yes/no diagnosis. Use them as one data point, not the decision-maker. Gut Microbiome & Histamine: Why Probiotics Matter Your gut is both a source and a sink for histamine. Certain bacteria possess the histidine decarboxylase (HDC) genes that convert histidine to histamine. Others contribute indirectly by influencing gut permeability, immune tolerance, and inflammatory tone. Dysbiosis—especially reduced beneficial butyrate producers and overgrowth of histaminogenic species—appears more common in patients reporting histamine intolerance. Probiotics can help at multiple levels: Compete with or crowd out histamine-producing bacteria. Support tight junction integrity and reduce antigenic load crossing the gut barrier. Produce short-chain fatty acids (SCFAs) and other metabolites that modulate immune signalling. Down-regulate inflammatory mast cell activation and histamine receptor expression (strain-specific). In some cases, increase DAO activity indirectly (early data; not proven across strains). Because the research is still developing, probiotic selection is best guided by strain data + clinical tolerance rather than internet myth. Let’s dig in. Probiotics for Histamine Intolerance: What We Know Important:  Effects are strain-specific, not just species-specific. Not every Lactobacillus plantarum behaves the same way. When possible, choose products that list strain IDs (e.g., Bifidobacterium longum BB536; Lactobacillus rhamnosus GG). Below is an evidence-informed (and clinic-tested) guide to selecting probiotic categories when histamine intolerance is suspected. Low-Histamine / Histamine-Lowering Bifidobacterium Strains Why they matter:  Many Bifidobacterium species support gut barrier repair, reduce inflammatory signalling, and may help reduce histamine sensitivity indirectly. Some combination products demonstrate benefit in allergy symptom scores, a histamine-mediated process. Commonly used strains in low-histamine protocols: Bifidobacterium longum (including subspecies longum BB536; immune modulation; gut barrier support). Bifidobacterium infantis (tolerability in sensitive guts; anti-inflammatory signalling). Bifidobacterium bifidum (mucosal immune crosstalk). Bifidobacterium breve (broad gut support; often included in blends). Clinical use tips:  Start with a single-strain bifido or a bifido-dominant blend if very reactive. Use powder or low-dose capsule titration (sprinkle method) for sensitive patients. Lactobacillus plantarum & Lactobacillus rhamnosus These two are among the most frequently recommended probiotics for histamine intolerance because of their immune-calming potential. L. plantarum Supports the intestinal barrier and may reduce inflammatory cytokines. Included in multi-strain formulas shown to improve allergy-related quality-of-life scores. Often well tolerated even in moderately histamine-reactive patients. L. rhamnosus  (notably strain GG) Extensively researched for gut and immune health. It may help modulate IgE-related reactivity and histamine receptor expression. Good “first Lactobacillus” to trial after bifido tolerance is established. Saccharomyces boulardii & Spore-Based Options A non-bacterial probiotic yeast, S. boulardii is often tolerated when bacterial probiotics flare symptoms. Early data and practitioner experience suggest possible support for intestinal enzyme function (including DAO), gut barrier repair, and pathogen crowd-out. It’s a useful bridge for patients who react even to low-histamine bacterial strains. Spore-forming Bacillus species (e.g., B. coagulans, B. subtilis blends) can help diversify the microbiome and support immune tolerance; however, sensitivity varies. Introduce late and low in highly reactive cases. The Lactobacillus reuteri Paradox You’ll often see L. reuteri listed as a “histamine producer”—and that’s partly true: some strains can produce histamine locally in the gut. Paradoxically, that produced histamine may down-regulate inflammatory TNF-α signalling via specific histamine receptors, yielding an anti-inflammatory effect in experimental models. Translation: L. reuteri isn’t automatically off-limits; it’s just not a first-line strain when symptoms are unstable. Reserve for later-stage gut rebuilding if clinically indicated. What About Multi-Strain Blends? Multi-strain “histamine smart” blends (often bifido-heavy, with carefully selected low-histamine lactobacilli) can be effective after individual tolerance is confirmed. Examples on the market combine B. longum, B. infantis, B. bifidum, B. breve, L. plantarum, L. salivarius, and sometimes S. boulardii. For sensitive patients, I typically: Confirm tolerance to one bifido strain. Layer in a compatible Lactobacillus (plantarum or rhamnosus). Transition to a targeted blend if the goal is long-term microbiome diversity. How to Introduce Probiotics When You’re Reactive Histamine-sensitive patients often react to “normal” probiotic dosing. Use a low-and-slow titration ladder: Step 1 – Symptom Baseline:  Track 3–5 days of usual symptoms, diet, and bowel function. Step 2 – Start Single Low-Histamine Strain:  Open capsule; take 1/16–1/8 of the dose in water with food every other day for three doses. Step 3 – Gradual Up-Titration:  If tolerated, increase by small increments every 3–4 doses (not daily) until full label dose or clinically effective dose reached. Step 4 – Observe for 7–10 Days:  Watch for improvements: less flushing after meals, better stool form, reduced reactivity to borderline foods. Step 5 – Add Second Strain Category:  Repeat process; do not stack two new strains at once. If Reactions Occur:  Pause 3–5 days; restart at half prior tolerated amount; consider switching strain category (e.g., from Lactobacillus to Bifido or to S. boulardii). Clinician note:  Many “reactions” are actually die-off, motility change, or GI immune recalibration. Distinguish transient gas/bloating from reproducible hives, migraines, or tachycardia. Low-Histamine Diet: Reset, Not Forever A therapeutic low-histamine reset (2–4 weeks) can calm symptoms enough to reintroduce gut-healing foods and probiotics. Long-term, ultra-restrictive histamine elimination risks nutrient deficiency, microbiome loss of diversity, and food fear. Core Principles Emphasize freshly prepared foods; freeze leftovers immediately in portion sizes. Avoid long-storage proteins (aged, smoked, cured, deli meats) during reset. Rotate produce; don’t over-restrict fruits/veg without cause (some low histamine lists out there can be excessive and unnecessary) Trial higher histamine foods later (if/when stable) in teaspoon (or what I sometimes refer to as micro-dosed) amounts. Use a food + symptom tracker to identify threshold patterns rather than permanent “never” lists. Common higher-histamine or triggering foods during the reset:  alcohol, fermented foods (sauerkraut, kombucha), aged cheeses, cured/processed meats, smoked fish, leftover meats, bone broth simmered very long, pickles, vinegar-heavy dressings, tomatoes, spinach, eggplant, avocado (variable), canned fish. Generally lower histamine (when fresh):  freshly cooked chicken/turkey, freshly frozen fish, most fresh leafy greens except spinach, cooked root vegetables, gluten-free grains (rice, quinoa, millet, buckwheat), pears, apples, blueberries, most herbs. Supporting DAO & Gut Integrity Because histamine load depends on both input and clearance, supporting DAO and gut repair can expand tolerance. DAO Support Strategies DAO Enzyme Supplements:  Use with higher-histamine meals (eating out, parties, wine & cheese nights). Not a cure—an assist. Nutrient Cofactors:  DAO synthesis and activity require adequate vitamin B6, copper, zinc, vitamin C, and possibly manganese. Reduce DAO Blockers:  Minimize or space alcohol, certain teas/energy drinks, and medications known to interfere when possible (always consult prescribing physician). Gut Repair & Mast Cell Calming Adjuncts Target SIBO, post-infectious IBS, or overgrowths contributing to dysbiosis. Use anti-inflammatory foods: omega-3 rich fish (fresh), ground flax, chia; polyphenol-rich but low-histamine produce. Consider quercetin, vitamin C, and bromelain combinations for mast cell modulation (case-by-case, always consult your naturopath before introducing supplements). Histamine Intolerance Treatment Approach Below is the phased framework I use in the clinic when supporting patients with suspected histamine intolerance. Phase A – Assess Symptom inventory across body systems. Diet & trigger review (alcohol, leftovers, fermented foods, supplements). Medication screen for DAO interference. Labs as appropriate: serum DAO activity, nutrient cofactors, SIBO breath, stool microbiome, inflammatory & barrier markers. Phase B – Reduce Load 2–4 week low-histamine reset. Remove/discontinue (temporarily) high-risk foods and alcohol. Initiate short-term DAO enzyme with restaurant meals. Phase C – Rebuild Gut Terrain Introduce a single low-histamine probiotic strain (bifido-first for most sensitive patients). Add targeted prebiotic fibres only after acute symptoms calm (acacia fibre, partially hydrolyzed guar gum if tolerated). Address dysbiosis/SIBO with herbal or antimicrobial protocols as indicated. Phase D – Rebalance Immune Response Layer in second/third probiotic categories (L. plantarum, L. rhamnosus; later S. boulardii or spore-based). Add mast cell-stabilizing nutrients (quercetin, luteolin blends) when needed. Restore fermented foods in micro-doses to support microbial diversity. Phase E – Reintroduce & Personalize Systematic reintroduction of moderate-histamine foods; identify threshold. Shift diet toward diversity, not restriction . Maintain symptom-aware lifestyle (stress, sleep, menstrual cycle tracking, alcohol spacing). FAQs: Probiotics & Histamine Intolerance Do probiotics always help with histamine intolerance? Not always—but the right strain at the right time often reduces symptom flares over 6–12 weeks. Some strains may worsen symptoms initially; that’s why guided titration and expert guidance matter. Which probiotic should I start with if I’m very sensitive? You should typically start with a single-strain Bifidobacterium (such as B. longum or B. infantis) at a fraction of the label dose. If tolerated, I layer in L. plantarum or L. rhamnosus. Can I take probiotics if I have SIBO and histamine intolerance? Yes—but sequence matters. Treating SIBO often reduces histamine symptoms and eliminates the possible underlying cause. Use S. boulardii or spore-based formulas carefully, and consider starting it post-antimicrobial therapy. Are fermented foods always bad? No. They’re naturally high in histamine, but once your system is more stable, you may tolerate small, frequent amounts better than large, infrequent servings. Always reintroduce slowly. How long before I notice improvement? Some patients report reduced flushing and headaches within 2–3 weeks of load reduction + probiotic support; broader food tolerance often improves over 3–6 months. Work With Dr. Courtney Holmberg, ND in Toronto Histamine intolerance can be frustrating, isolating, and confusing—especially when “healthy” foods make you feel worse. I help patients across Ontario identify root causes, calm reactivity, and rebuild tolerance using a structured, evidence-informed naturopathic protocol that includes diet, targeted probiotics, DAO support, mast cell modulation, and gut repair. Ready for personalized care? Book an appointment at our Toronto Naturopathic Clinic . Ask about gut microbiome & histamine testing panels. Get a customized probiotic & reintroduction plan that fits your lifestyle. Call:   (647) 351-7282 Practice:   Dr. Courtney Holmberg, ND – Toronto Naturopathic Doctor www.courtneyholmbernd.ca

Heartburn is one of the most common digestive complaints I see in clinic. That burning sensation in the chest or throat—often after meals—can be caused by certain foods, stress, or lifestyle habits. While medications may offer quick relief, they don’t address why heartburn is happening in the first place. The good news? There are safe, effective natural treatments for heartburn  that work with your body to reduce symptoms, heal irritated tissues, and prevent flare-ups. A Naturopathic Doctor in Toronto focuses on identifying and treating the root cause, so relief is lasting—not just temporary. What is the Goal of Natural Treatment for Heartburn? Naturopathy blends modern medical science with natural therapies—like nutrition, herbal medicine, and lifestyle counselling—to restore balance and help the body heal. For heartburn (also called acid reflux or GERD), naturopathic care looks beyond stomach acid levels alone. Common contributors include: Food triggers and meal timing Weak digestive function Stress and nervous system imbalance Gut microbiome disruptions Inflammation in the esophagus or stomach By addressing these underlying issues, we can reduce both the frequency and severity of symptoms naturally. Diet Changes for Natural Heartburn Relief Your diet directly impacts acid reflux. A personalized naturopathic heartburn relief plan might include: Avoiding common triggers:  Spicy, fried, citrus-based, tomato-based, and caffeinated foods. Eating smaller, more frequent meals:  Prevents excess stomach pressure and reflux. Staying hydrated between meals:  Sipping water outside of mealtime helps maintain healthy digestion. Making small, consistent food changes is often the most impactful step in a natural treatment for heartburn. Herbal Remedies for Heartburn Several herbs have been shown to ease acid reflux naturally by soothing and protecting the digestive tract: Antinflammatories like Ginger:  Supports healthy digestion and reduces inflammation. Nervines like Chamomile:  Anti-inflammatory and calming—ideal as an after-dinner tea. Demulcents like Deglycyrrhizinated Licorice (DGL):  Helps protect and heal irritated mucosal tissues. These herbal remedies for heartburn can be tailored to your specific symptoms and health history. Stress Management to Prevent Acid Reflux Stress is a well-known reflux trigger, increasing stomach acid production and slowing digestion. Natural stress-reduction techniques include: Mindful breathing before meals  to support the “rest-and-digest” state. Gentle yoga or stretching  to relax the nervous system. Prioritizing quality sleep  to reduce overall stress load. Reducing stress often leads to noticeable improvement in reflux frequency and intensity. Probiotics for Digestive Health A healthy gut microbiome plays a vital role in preventing acid reflux and supporting digestion. Probiotic-rich foods and supplements can help restore balance and reduce inflammation. Options include: Yogurt or kefir (dairy or plant-based) Sauerkraut, kimchi, and other fermented vegetables Miso and tempeh When considering probiotics for heartburn, they should always include at least one of the following strains: 1. Lactobacillus gasseri LG21 Evidence:  Clinical trials in Japan have shown LG21 can help reduce symptoms of functional dyspepsia and reflux by improving gastric emptying and suppressing H. pylori overgrowth (a known reflux trigger). How it helps:  Enhances stomach mucosal protection and reduces acid backflow. 2. Lactobacillus reuteri DSM 17938 Evidence:  It has been shown to reduce regurgitation frequency in infants and improve gut motility in adults. How it helps:  Increases mucosal barrier health and helps regulate stomach emptying time. 3. Lactobacillus rhamnosus GG (LGG) Evidence:  Supports gut barrier repair, reduces inflammation, and may reduce esophageal irritation in reflux patients. How it helps:  Strengthens the gut lining and modulates immune-driven inflammation in the esophagus. 4. Bifidobacterium lactis HN019 Evidence:  Improves intestinal motility, which may prevent delayed gastric emptying (a common reflux trigger). How it helps:  Reduces bloating and post-meal pressure that can push stomach acid upward. 5. Lactobacillus plantarum 299v Evidence:  Known to reduce gut permeability (“leaky gut”), improve digestion, and reduce gas/pressure in the stomach. How it helps:  By easing bloating, it can indirectly reduce acid reflux episodes. A customized probiotic plan can make a significant difference in natural remedies for acid reflux. Lifestyle Habits That Support Heartburn Relief Small daily habits can make a big difference in keeping reflux at bay: Avoid lying down for 2–3 hours after eating Maintain a healthy weight  to reduce abdominal pressure Quit smoking , which weakens the lower esophageal sphincter The Bottom Line: A Holistic Approach Works Best Heartburn is your body’s way of signalling a deeper imbalance in digestion. Instead of masking symptoms with medication, a natural treatment for heartburn works to correct the cause—whether it’s food triggers, stress, or microbiome health—so relief is lasting. If you’re looking for support to heal your digestion naturally, book a consultation with Dr. Courtney Holmberg, Toronto Naturopathic Doctor, to help you create a personalized plan that works for your lifestyle. Call (647) 351-782 or book your consultation today to schedule your visit here.

Let’s be honest - hair is often a defining feature of our appearance and an extension of our identity. For many women, our hair is also a means of self-expression. That's why hair loss can be very distressing and impact self-esteem. There are various reasons why women experience hair loss, ranging from genetics to lifestyle factors. In this blog, we will explore the most common causes of women's hair loss and shed light on potential solutions. Androgenetic Alopecia (Female Pattern Hair Loss) Androgenetic alopecia, also known as female pattern hair loss, is one of women's most prevalent causes of hair loss. Androgens are a group of hormones, including testosterone, which are predominant in men but are also produced in smaller amounts in women. Hair follicles in the scalp have androgen receptors, which means they can be influenced by these hormones. In some cases, when the balance between androgens and other hormones shifts, hair follicles can become more sensitive to the androgens. This increased sensitivity can lead to a process called "miniaturization," where hair follicles shrink over time and produce thinner, shorter, and less pigmented hair strands. Genetics plays a significant role in determining susceptibility to this condition. Conventional treatment options range from topical minoxidil solutions to prescription medications like spironolactone and finasteride, but often only help while in use and may not resolve the issues long term. Nutritional Deficiencies Vitamins and minerals are essential for hair growth and maintenance. Deficiencies in nutrients like iron, biotin, zinc, and vitamin D can lead to hair loss. Iron is often the most common cause seen in practice, with research suggesting approx 60% of individuals experiencing hair loss present with iron deficiencies. A balanced diet rich in lean proteins, nuts and seeds, vegetables, and dark leafy greens can help combat hair loss due to nutritional deficiencies. Hormonal Changes Hormonal fluctuations can also play a substantial role in women's hair loss. Hormones naturally fluctuate in women due to various life stages such as puberty, pregnancy, postpartum, and menopause. These fluctuations can impact the hair growth cycle. During pregnancy, for example, higher estrogen levels prolong the growth phase (anagen) of the hair cycle, resulting in fuller hair. However, estrogen levels drop rapidly after childbirth, and many hairs enter the resting (telogen) phase simultaneously, leading to postpartum hair shedding. Hormonal changes during menopause can also lead to hair thinning due to decreased estrogen levels and potential androgen dominance. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders (hypothyroidism and hyperthyroidism), and chronic stress can also lead to hair thinning. Treating the underlying hormonal imbalance often results in improved hair health. Telogen Effluvium Telogen effluvium is a reversible condition that occurs when there is an abrupt shift in the hair growth cycle. This shift leads to increased hair follicles entering the resting (telogen) phase, followed by shedding. Common triggers include significant physical or emotional stress, major surgeries, rapid weight loss, childbirth, and certain medications. The hair loss is diffuse and occurs all over the scalp. While not much can be done to immediately reverse the shedding, managing the underlying cause and ensuring a balanced diet rich in vitamins and minerals can aid hair regrowth. Traction Alopecia Traction alopecia is a form of hair loss caused by repeated pulling or tension on the hair follicles. Tight hairstyles like braids, weaves, and ponytails can lead to hair loss, particularly around the hairline and temples. Avoiding tight hairstyles and giving hair regular breaks can prevent further damage. Medical Conditions and Medications Certain medical conditions such as alopecia areata (an autoimmune disorder), lupus, and scalp fungal infections can lead to hair loss. Additionally, some medications used to treat cancer, depression, arthritis, and high blood pressure can have hair loss as a side effect. Stress Chronic stress can disrupt the normal hair growth cycle. Elevated cortisol (aka our ‘stress’ hormone) disrupts the normal hair growth cycle by pushing more hair follicles into the resting phase, resulting in hair shedding. Practicing stress management techniques such as meditation, yoga, and deep breathing can help mitigate its effects on hair health. Hair loss in women can result from a combination of genetic, hormonal, nutritional, and lifestyle factors. Understanding the root causes of hair loss is the first step toward finding effective solutions. If you're experiencing significant hair loss, it's advisable to consult your healthcare professional to identify the underlying cause, as it may often not be one factor in isolation causing the hair loss, and more importantly, hair regrowth may not occur under the root cause has been accurately addressed. If you aren’t sure what to do about hair loss, call (647) 351-7282 for a consultation with Dr. Courtney Holmberg, a Naturopathic Doctor in Toronto . Dr. Holmberg will assist in getting answers as to why your hair is falling out and solutions to address the issue and improve your overall health. Make an appointment today to learn more about testing and a natural approach to health. References: Treister-Goltzman Y, Yarza S, Peleg R. Iron Deficiency and Nonscarring Alopecia in Women: Systematic Review and Meta-Analysis. Skin Appendage Disord. 2022 Mar;8(2):83-92. doi: 10.1159/000519952. Epub 2021 Nov 19. PMID: 35415182; PMCID: PMC8928181. Ho CH, Sood T, Zito PM. Androgenetic Alopecia. [Updated 2022 Oct 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430924 Birch MP, Lalla SC, Messenger AG. Female pattern hair loss. Clin Exp Dermatol. 2002 Jul;27(5):383-88. doi: 10.1046/j.1365-2230.2002.01085.x. PMID: 12190638. Sinclair R, Patel M, Dawson TL Jr, Yazdabadi A, Yip L, Perez A, Rufaut NW. Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness. Br J Dermatol. 2011 Dec;165 Suppl 3:12-8. doi: 10.1111/j.1365-2133.2011.10630.x. PMID: 22171680.

From cold plunges to contrast showers, cold therapy has become a mainstream wellness trend. It's all over TikTok and Instagram—but unlike most trends, this one actually has some science behind it. As a Naturopathic Doctor , I’m always interested in zero or low cost therapies that tap into the body’s innate ability to heal—and cold exposure is no exception. But like any intervention, it’s not universally beneficial, and the female body has unique considerations we can’t ignore. Let’s unpack the researched benefits (and limitations) of cold therapy for women’s hormones, muscle development, recovery, and metabolism, along with what you should know before diving in. Cold Exposure & Hormonal Health in Women Cold therapy triggers a surge in norepinephrine, a catecholamine hormone involved in alertness, mood, and metabolism. This hormonal response can support mental clarity and resilience, and may have therapeutic potential for women navigating mild depression, PMS-related mood swings, or burnout. However, chronic or excessive cold stress may negatively affect hormone balance, particularly in women with already taxed adrenals, low body fat, or irregular cycles. Inadequate caloric intake paired with intense cold exposure may blunt ovulation or lower progesterone levels over time. Bottom line: A little cold stress can build resilience and boost mood, but overdoing it may dysregulate your cycle. If you're already dealing with hypothalamic amenorrhea, adrenal dysfunction, or thyroid imbalances, approach cold exposure with caution. Cold Therapy & Muscle Recovery in Female Bodies For active women, cold therapy can be a powerful tool for post-exercise recovery. Ice baths, cold showers, or cryotherapy may: Reduce delayed-onset muscle soreness (DOMS) Lower inflammation and tissue swelling Speed up return to training However, there's nuance here: studies suggest that immediate cold exposure after strength training may blunt muscle protein synthesis and hypertrophy—especially important for women trying to build lean mass. My advice: If your goal is muscle growth, skip the ice bath right after lifting. Instead, use it on rest days or after endurance workouts to speed up recovery without compromising gains. Cold Therapy, Metabolism & Body Composition One of the more interesting effects of cold exposure is its ability to activate brown fat, a metabolically active type of fat that burns calories to generate heat. In women, this activation may support: Improved insulin sensitivity Better glucose control A modest increase in resting metabolic rate It’s not a magic bullet for fat loss, but it can complement a well-rounded metabolic health strategy. Consistency, not intensity, matters most. Additional Benefits Worth Mentioning Mood & Resilience:  That cold shock increases dopamine and endorphins, which may explain the post-plunge high. Some women report fewer anxiety symptoms and better mental clarity after regular use. Sleep Quality:  Cooling the core body temperature before bed (even with a cold shower) may improve deep sleep cycles and reduce nighttime wakeups. Immune Function:  Emerging research links cold exposure to a modest increase in white blood cell activity, potentially helping your immune system stay on alert. Cold Therapy Risks—Especially for Women While cold exposure can be highly beneficial, it’s not for everyone, and the risks increase if it’s done unsafely or without proper adaptation: Cold shock & hyperventilation:  Never practice breath holds or forced hyperventilation before cold plunges—this can lead to shallow water blackouts. Thyroid & adrenal considerations:  Women with hypothyroidism, adrenal insufficiency, or very low body fat may struggle with cold regulation and could see worsening fatigue or hormonal disruption. Cycle sensitivity:  Some women find cold plunges increase menstrual cramping or dysregulate their cycles if done excessively or during certain phases. Start with shorter exposures at moderate temps (10–15°C or 50–59°F) for 1–2 minutes. Work your way up, and always listen to your body. What does the research show to be most beneficial in terms of time and temperature? 11 total minutes per week, 10°C of full body exposure. Final Thoughts: Is Cold Therapy Right for You? Cold therapy has a lot to offer—from faster recovery and better sleep to a stronger, more resilient nervous system. But women need to take a hormone-aware approach, especially if your goal includes balancing your cycle, building muscle, or supporting metabolism. As always, individuality matters. If you’re interested in personalized ways to optimize your hormones, metabolism and mental health, reach out to Toronto Naturopathic Doctor, Dr. Courtney Holmberg at (647) 351-7282 or  book an appointment online .

Why Biomarkers Matter for Prevention & Longevity Modern chronic diseases rarely appear overnight. Subtle metabolic shifts, nutrient shortfalls, inflammatory changes, and hormone imbalances can be present for years before symptoms meet a diagnostic threshold. Biomarker Testing —measurable indicators in blood and other body fluids—offer an evidence-informed way to see those shifts early, intervene sooner, and support a longer healthspan (years lived in good health, free from disability and disease). When tracked over time, targeted biomarker assessments can help: Flag trends toward insulin resistance, cardiovascular risk, or nutrient depletion before disease develops. Correlate lab findings with symptoms such as fatigue, weight changes, mood shifts, and menstrual irregularities, then consider  female hormone testing . Personalize nutrition, supplementation, and lifestyle plans. Monitor the impact of treatment and make timely course corrections. The Gap: Access to Preventative Blood Work Isn’t Always Easy in Ontario In Ontario’s publicly funded system, lab testing is generally ordered when it meets medical-necessity criteria. That means proactive or more frequent screening—especially when you feel "fine" but want deeper insight—isn’t always accessible through standard channels. Many people are told their basic labs are "normal," or denied more regular screening due to their age, yet continue to experience symptoms, or they want more detailed markers that aren’t routinely run. This is where a naturopathic doctor-led biomarker strategy can bridge the gap. By combining a detailed health history with targeted lab selection, you gain access to data that informs preventative, individualized care. What a Naturopathic Doctor Brings to Biomarker Assessment Working with a licensed naturopathic doctor in Ontario provides access to an array of preventative blood work a clinical setting that goes beyond a one-time test kit. Key advantages: Comprehensive Intake Appointment:  Symptoms, lifestyle, diet, medications, and health goals inform which biomarkers matter most. Targeted test selection:  Avoid paying for unnecessary panels; invest in the markers most relevant to you. Optimal vs. conventional ranges:  Understand when results are technically "normal" but trending away from metabolic or hormonal resilience. Root-cause context:  Integrate biomarkers with functional systems—gut, hormones, immune, detox, metabolism. Actionable treatment plans:  Nutrition upgrades, supplementation, botanical medicine, stress recovery, sleep, movement, and when collaborative medical care is indicated. Follow-up & trend tracking:  Re-test at appropriate intervals to measure change and support long-term prevention. Competing with big-box and digital lab startups (e.g., Nia Health & other direct-to-consumer platforms): ND-directed testing pairs data with individualized testing, interpretation, and clinical follow-through—key differentiators for long-term outcomes. Core Biomarker Categories Offered in an ND-Led Preventative Panel Below is a modular framework commonly used to build customized biomarker testing panels. Not every marker is needed for every person; selection is based on history, risk, age, symptoms, and goals. Metabolic Health & Blood Sugar Regulation Fasting glucose & insulin (calculate HOMA-IR) HbA1c (long-term glucose trend) C-peptide (insulin production insight) Cardiovascular & Lipid Risk Expansion Standard lipid profile (total, LDL-C, HDL-C, triglycerides) ApoB   (atherogenic particle count proxy) CRP (vascular inflammation) Inflammatory & Immune Activity CRP (systemic inflammation) ESR Ferritin (also an acute phase reactant; interpret in context) Fibrinogen (when cardiovascular risk warrants) Nutrient Status & Functional Sufficiency Ferritin + iron/TIBC + % saturation Vitamin B12 & Homocysteine Folate (serum or RBC) 25-OH Vitamin D RBC magnesium (preferred over serum, if accessible) Zinc, copper, selenium (selectively, based on need) Hormone & Thyroid Health TSH, free T4, free T3 Thyroid antibodies (TPOAb, TgAb) for autoimmune screening Reverse T3 (contextual; not routine for all) Female hormone mapping (estradiol, progesterone, LH, FSH; cycle-timed) Androgen status (DHEA-S, total & free testosterone) when indicated Prolactin (selective) Liver, Detox & Methylation Indicators ALT, AST, GGT, ALP, bilirubin Albumin, total protein, and globulin ratio Homocysteine (methylation & cardiovascular linkage) FIB-4 (fibrosis estimate) 7. Kidney & Electrolyte Balance Creatinine, eGFR BUN Electrolytes (sodium, potassium, chloride, bicarbonate) Urinalysis (protein, glucose, specific gravity, ketones, etc.) Gut & Food-Related Screening (Selected Cases) Celiac serology (tTG-IgA ± total IgA) H. pylori breath or stool antigen Calprotectin (stool, inflammatory marker) Longevity & Systems Resilience Indicators hs-CRP (again—because trend matters) Insulin & HOMA-IR trends ApoB for lifetime cardiovascular burden Omega-3 index Note:  Availability varies by lab. Some markers require specialty or out-of-province processing. Dr. Holmberg, ND will guide selection. Sample Custom Panels by Health Goal Below are sample biomarker testing groups frequently requested in the clinic. Use them as building blocks to assess certain concerns; each patient’s panel is individualized. Foundational Preventative Screen (General Adult) CBC with differential CMP (electrolytes, kidney, liver) Lipid profile + non-HDL Fasting glucose, HbA1c, insulin hs-CRP Ferritin, B12, 25-OH Vitamin D Women’s Hormone & Energy Panel (Reproductive Age) Foundational Preventative Screen + TSH, free T4, free T3, TPOAb Day-specific estradiol, progesterone DHEA-S, testosterone (if symptoms) Iron panel (if heavy periods) Perimenopause / Midlife Metabolic Reset Foundational Preventative Screen + FSH, LH, estradiol, progesterone (cycle stage dependent) DHEA-S, testosterone (total/free) hs-CRP, ApoB, Lp(a) Fasting insulin & HOMA-IR trend Plant-Based / Vegan Nutrient Audit CBC (macrocytosis screen) Ferritin + iron panel B12 (± methylmalonic acid if accessible) Folate Vitamin D Zinc & copper ratio (selective) Omega-3 index (if offered) How Biomarker Testing Works with Dr. Courtney Holmberg, ND Step 1 – Initial Consultation Discuss symptoms, goals, medical history, medications, supplements, and lifestyle factors that influence lab needs. Step 2 – Personalized Lab Plan A targeted requisition (or modular panel) is designed, no paying for dozens of irrelevant tests. Step 3 – Sample Collection Blood draw arranged through partnered private lab services in Toronto / GTA. Some specialty kits may be done at home. Step 4 – Results & Interpretation Visit Labs are reviewed in detail, highlighting patterns, early risk signals, and opportunities for nutritional or lifestyle intervention. Step 5 – Action Plan & Monitoring Receive a stepwise plan: dietary changes, supplementation protocols, stress & sleep strategies, movement prescriptions, and—when appropriate—collaborative referrals for medical evaluation. Step 6 – Re-Test & Trend Monitoring intervals are set based on goals (e.g., 3, 6, or 12 months) to track improvement and adjust care. Who Should Consider Biomarker Testing? You don’t need to be ill to benefit. Consider booking if you: Want proactive, preventative screening beyond the basics. Have ongoing symptoms despite "normal" labs. Carry a family history of diabetes, cardiovascular disease, autoimmune conditions, or hormone disorders. Are you planning a pregnancy or experiencing fertility challenges? Follow a restricted diet (vegan, low-iron, low-calorie, gluten-free) and want nutrient assurance. Are navigating perimenopause, irregular cycles, PCOS, or endometriosis. Are you an athlete or high performer tracking recovery, inflammation, and nutrient sufficiency? How Often Should Preventative Blood Work Be Repeated? Frequency depends on risk, age, and findings. General guidance: Baseline screen:  Establish your starting point. Every 12 months:  Preventative re-check for healthy, low-risk adults. Every 6 months:  Correcting a deficiency, monitoring metabolic change, adjusting hormones, or tracking inflammation. Every 3 months:  Intensive therapeutic phase (iron repletion, glycemic recovery, fertility cycles, medication changes). Understanding Lab Ranges: Normal vs Optimal Standard lab reference intervals capture ~95% of a tested population, not necessarily the "ideal health" window. Many individuals fall within the reference range yet experience symptoms linked to suboptimal, trending, or borderline labs. ND interpretation includes: Pattern recognition across markers (example: low ferritin + low B12 + macrocytosis). Functional thresholds associated with energy, cognition, immune function, menstrual health, or athletic output. Relative change from past results—improving or drifting? Insurance, Fees & Using Extended Health Benefits ND visit fees are typically covered under extended health benefit plans (check your insurer). Lab costs vary depending on the depth of your selected panel; pricing transparency is provided before testing (generally ranges from 200-500$) Some markers may be ordered through your medical doctor and covered by OHIP when medically necessary; panels can be hybridized to reduce out-of-pocket costs. Health spending accounts (HSAs/FSAs) can often be applied to ND services & testing. Preparing for Your Blood Draw Dr. Holmberg, ND, will provide guidance on all of the following to maximize accuracy: Confirm whether fasting (8–12 hrs) is required for glucose, lipids, and insulin. Take usual medications unless instructed otherwise. Pause certain supplements (biotin, high-dose biotin interferes with some assays; iron before ferritin draw; discuss individually). Hydrate well the day before. Schedule female hormone draws according to cycle day when relevant. Ready to see what your numbers say about your health? Book a comprehensive biomarker assessment with Dr. Courtney Holmberg , ND. Personalized interpretation. Prevention-focused care. Toronto & virtual Ontario appointments available. Book Your Biomarker Testing Visit

Endometriosis is one of the most underdiagnosed and misunderstood conditions impacting women's reproductive health. It affects an estimated 10% of women of reproductive age, yet many go years—sometimes decades—without a proper diagnosis. This condition not only causes chronic pelvic pain and severe menstrual symptoms but is also a major contributor to infertility. As a naturopathic doctor in Toronto , I aim to help you better understand the root causes of endometriosis, the tools we use to assess it, and the integrative treatment strategies available to support your health, fertility, and quality of life. What Is Endometriosis? Endometriosis occurs when tissue similar—but not identical—to the endometrial lining of the uterus begins to grow outside the uterus. This tissue is responsive to hormonal changes, especially estrogen, and undergoes cyclical inflammation and bleeding in response to your menstrual cycle. Common areas where endometriosis can form include: The ovaries Fallopian tubes Pelvic peritoneum Uterosacral ligaments Bladder or bowel In rare cases, even distant organs like the lungs This chronic inflammation leads to scarring, adhesions (bands of fibrous tissue that bind organs together), and often, significant pain. What Causes Endometriosis? The exact cause of endometriosis remains unclear, but current research points to a multifactorial origin. The leading hypotheses include: Retrograde menstruation : Menstrual blood flows backward through the fallopian tubes into the pelvic cavity, carrying endometrial-like cells. Immune dysfunction : An altered immune response may fail to clear misplaced endometrial cells, allowing them to implant and grow. Estrogen dominance : Elevated estrogen levels or poor estrogen detoxification can promote the growth of endometrial tissue. Genetic factors : There is often a family history of endometriosis, suggesting inherited susceptibility. Environmental toxins : Exposure to endocrine-disrupting chemicals (like dioxins or phthalates) may increase the risk of developing the condition. Common Symptoms to Watch For Endometriosis presents differently for each woman, and the severity of symptoms doesn’t always correlate with the extent of the disease. If you're experiencing the following signs, don’t dismiss them as "normal period pain": Severe menstrual cramping that affects your ability to work or function Chronic pelvic pain outside of menstruation Pain during intercourse, especially deep penetration Pain with bowel movements or urination (particularly during menstruation) Heavy or irregular menstrual bleeding Gastrointestinal symptoms such as bloating, nausea, constipation, or diarrhea Fatigue and low energy, often cyclical How is Endometriosis Diagnosed? While laparoscopic surgery remains the gold standard for a definitive diagnosis, non-invasive tools like advanced ultrasound imaging are becoming increasingly valuable in the diagnostic process. Ultrasound Techniques Transvaginal ultrasound, especially when performed by a skilled sonographer trained in endometriosis detection, can identify: Ovarian endometriomas ("chocolate cysts") Deep-infiltrating lesions Uterosacral ligament nodules Adhesions causing organ tethering When combined with a thorough clinical history and pelvic exam, imaging can often suggest a strong likelihood of endometriosis, even without surgery. That said, superficial peritoneal lesions often go undetected without laparoscopy, which is why clinical symptoms remain a key part of the diagnostic process. The Impact of Endometriosis on Fertility Endometriosis can impair fertility in several ways: Anatomical distortion : Adhesions may block the fallopian tubes or impair egg pickup. Ovarian dysfunction : Endometriomas can damage ovarian reserve and reduce egg quality. Inflammation : Chronic pelvic inflammation creates an environment that may be hostile to sperm, eggs, or implantation. Hormonal imbalance : Disrupted progesterone signalling and estrogen dominance can affect ovulation and implantation. Studies show that up to 50% of women with infertility may have endometriosis, making early recognition and treatment essential for preserving reproductive health. Treatment Options: A Functional and Integrative Approach Treatment depends on your symptoms, fertility goals, and how the condition is affecting your quality of life. Conventional medical options include: Hormonal therapies : Birth control, progestins, or GnRH agonists to suppress menstruation and slow tissue growth Surgical intervention : Laparoscopic excision of endometrial lesions, which offers symptom relief and may improve fertility outcomes, but has a high risk of regression. Pain management : NSAIDs or other analgesics But symptom management isn’t enough—we must also address the underlying drivers of inflammation, hormone imbalance, and immune dysfunction. Natural Strategies to Support Endometriosis While endometriosis isn’t “curable,” natural therapies can reduce symptoms, slow progression, and support fertility. Nutrition Anti-inflammatory diet : Emphasize wild fish (omega-3s), leafy greens, berries, turmeric, flax, and cruciferous vegetables. Limit : Red meat, alcohol, and ultra-processed foods, all of which can promote inflammation and estrogen imbalance. Targeted Supplements N-acetylcysteine (NAC) : Reduces oxidative stress and modulates inflammation. One study showed NAC reduced endometrioma size after 3 months. Turmeric (Curcumin) : Natural anti-inflammatory and COX-2 inhibitor. DIM or Calcium-D-glucarate : Supports estrogen detoxification. Omega-3 fatty acids : Shown to reduce menstrual pain and systemic inflammation. Magnesium + B6 : May reduce cramps and balance estrogen metabolism. Lifestyle Exercise:  This one is key! A 2017 study in the Journal of Physical Therapy Science found that low-impact aerobic exercise reduced pain intensity and improved quality of life in women with chronic pelvic pain due to endometriosis, and a 2019 review in Reproductive Sciences noted that physical activity can modulate immune and inflammatory responses, which may indirectly reduce lesion activity and pain in endometriosis patients. Practice restorative movement (yoga, Pilates, walking) to reduce cortisol and pelvic congestion. Sleep:  Prioritize sleep and stress reduction, which modulate the immune system and inflammation. If you’re struggling with unexplained pelvic pain, irregular cycles, or infertility, you deserve answers—and a plan that goes beyond symptom suppression. Naturopathic support for endometriosis combines comprehensive testing with target and individualized natural therapies to support your body’s inflammatory and hormonal cycles. Whether you're seeking to reduce pain, preserve fertility, or prepare for conception, living with endometriosis doesn't mean accepting your concerns as your normal. Call (647) 351-7282 to discuss your endometriosis concerns with Dr. Courtney Holmberg , Toronto-based Naturopathic Doctor.

We all know diet and exercise are key ingredients to weight loss. But an often overlooked and equally important ingredient is your sleep and stress. Without a healthy sleep routine and regulated stress levels, cortisol can climb, and it may be the factor keeping you from your weight loss goals. If you struggle with stubborn belly fat, fatigue, or intense cravings—despite eating well and exercising— it could be your cortisol levels at play. As a naturopathic doctor specializing in women’s health, digestion, and hormones, I (unfortunately) see this pattern all the time. Understanding how cortisol impacts weight gain (and learning how to balance it naturally) is the missing piece for many women trying to optimize their weight. How Cortisol Affects Your Weight Cortisol, often referenced as the “stress hormone,” is produced by your adrenal glands in response to daylight, exercise, and stress. It plays a key role in energy regulation, blood sugar balance, and inflammation. In small amounts, it’s helpful. But when stress is chronic—whether from work, lack of sleep, over-exercising, or even poor diet—cortisol levels stay elevated for too long, leading to: • Increased fat storage: Cortisol signals your body to store fat, particularly in the abdominal area. This is because your body perceives chronic stress as a threat and shifts into energy conservation mode, making weight loss more difficult. • Insulin resistance: Prolonged cortisol elevation can lead to blood sugar imbalances, making your cells less responsive to insulin. This can contribute to weight gain, increased cravings, and even pre-diabetes over time. • Slower metabolism: High cortisol can suppress thyroid function (by increasing reverse T3), slowing down your metabolic rate and making it harder to burn calories efficiently. • Muscle breakdown: Chronically elevated cortisol promotes muscle catabolism, breaking down muscle tissue for energy. This not only makes toning up more difficult but also reduces overall metabolic efficiency since muscle is key for burning calories at rest. • Increased hunger and cravings: Cortisol increases ghrelin (the hunger hormone) while decreasing leptin (the satiety hormone), leading to increased cravings, especially for sugar and refined carbohydrates. • Disrupted sleep patterns: Poor sleep, often caused by high evening cortisol levels, further exacerbates metabolic dysfunction, leading to increased fat storage and hormonal imbalances. • Gut microbiome imbalances: Chronic stress and elevated cortisol negatively impact gut health, reducing beneficial bacteria and increasing gut permeability. This can contribute to inflammation, digestive discomfort, and further metabolic disruption. Since the gut microbiome plays a crucial role in metabolism and weight regulation, imbalances here can make it even harder to lose weight. Balancing cortisol isn’t just about reducing stress—it’s about supporting your body’s natural rhythm so that your metabolism can work efficiently. 5 Natural Ways to Balance Cortisol and Support Weight Loss Optimize Your Diet for Regulated Cortisol Skipping meals, consuming too much caffeine, or eating processed foods can send cortisol on a rollercoaster. Focus on whole, nutrient-dense foods: • Protein: Stabilizes blood sugar and prevents energy crashes. • Healthy fats: Support hormone production (think avocado, nuts, and wild-caught fish). • Magnesium-rich foods: Help calm the nervous system (dark leafy greens, almonds, pumpkin seeds). • Vitamin C: Supports adrenal function (citrus fruits, bell peppers, strawberries). Prioritize Restorative Sleep Poor sleep disrupts cortisol’s natural rhythm, keeping it elevated when it should be winding down. It isn't always just about the amount of sleep you get, but also the quality (duration of deep and REM sleep). Establishing a healthy sleep routine should start with the following: • Aim for 7-9 hours of quality sleep. • Avoid screens 1-2 hours before bed. Also avoid late exercise, too much caffiene, and eating before bed, because these can all decrease the amount of sleep sleep you get. • Incorporate relaxation techniques like herbal teas, magnesium, or deep breathing before bedtime. • If you're a mouth breather, consider mouth taping! Use Adaptogenic Herbs for Stress Resilience Adaptogens are herbs that help your body adapt to stress without overproducing cortisol. Some of my favourites for women include: • Ashwagandha: Lowers cortisol and reduces anxiety. • Holy Basil: Supports stress adaptation and blood sugar balance. • Rhodiola: Helps with energy and mental clarity, especially if burnout is a concern. • Exercise Smarter, Not Over-exercising can actually spike cortisol, making fat loss harder. Swap high-intensity workouts for cortisol-friendly movement: • Strength training (2-3 times per week) • Walking or gentle yoga • Low-intensity interval training (LIIT) instead of high-intensity interval training (HIIT) if you feel constantly exhausted Manage Stress with Nervous System Support Chronic stress leads to chronically high cortisol, so daily stress management is key. Simple but powerful techniques include: • Breathwork: is a powerful, science-backed tool for regulating cortisol and supporting stress resilience. Deep breathing stimulates the vagus nerve, which signals the body to shift from a sympathetic (stress) state to a parasympathetic (relaxed) state. This helps lower cortisol production and reduces the physiological effects of stress. • Mindful eating: Sit down, chew slowly, and be present with your meals. • Boundaries: Say no to unnecessary stressors and protect your energy. The Bottom Line: Balance Cortisol for Lasting Weight Loss Weight loss isn’t just about calories—it’s about hormones, nutrition, and metabolism working in syngery. By supporting your body with the right foods, movement, herbs, and stress-reducing techniques, you can restore balance and finally see the results you’ve been working for. If you’re struggling with weight loss, fatigue, or hormone imbalances, consider looking into diagnostics that take a closer look at how your metabolism & hormones are performing. Through comprehensive testing and naturopathic strategies tailored to your unique body, we’ll uncover the root cause of why your current strategies may not be working for you. To learn more about the testing and strategies for optimizing your hormone health, reach out to Toronto Naturopathic Doctor Courtney Holmberg at (647) 351-7282 today.

As a naturopathic doctor dedicated to promoting 'healthspan' (aka the length of time a person is healthy and free from chronic disease), I often find myself in front of frustrated patients who have been met with resistance from our public health on the ability to access preventative measures for their health.  ​ Unfortunately, this is one major place where our health care system falls short, as it appears to have evolved into what I commonly refer to as a 'sick care' system. Unless you are presenting with overt symptoms, you are presumed to be 'fine'. But without blood work, we're given no objective information to base this on. I sit across from patients on the daily who have asked and been denied the baseline knowledge on their health and report feeling like this information is being gatekept from them. In a world where chronic diseases like diabetes, heart disease, and cancer are rampant, prevention becomes paramount. The value of preventative blood work Blood work is a window into the body's inner workings, and it provides numerous insights into various aspects of our health, from cholesterol levels to organ function and beyond. By analyzing key markers in your blood, we're able to detect potential issues early on, often before symptoms arise. Furthermore, it provides baselines to monitor change, allowing us to identify issues as they arise and before they become disease. Imagine being able to intercept health concerns before they escalate into full-blown diseases. Early detection is precisely what preventative blood screening offers. By identifying abnormalities in your blood chemistry, we can intervene swiftly with lifestyle changes, medication, or other interventions to halt the progression of disease. But how can we prevent what we cannot see? This is where blood screening becomes invaluable. Introducing 'The Wellness Check' After years of watching patients turn to private healthcare platforms and expensive medical clinics to collect the information they are after in regards to their health longevity, I've formulated a series of tests in which I'm referring to as The Wellness Check - a comprehensive list of biomarkers that provides objective insight into our most important bodily systems. Preventative screening can be as simple as a blood draw. The Wellness Check includes 48+ biomarkers to gain comprehensive insight into all areas of your health, including the following: ​ ✓ inflammation markers ✓ metabolism ✓ hormonal health  ✓ heart health  ✓ detoxification ✓ recovery & endurance ✓ nutrition status  In today's era of information proliferation, knowledge confers power. Equip yourself with insights into your health by considering preventative blood screenings, and adopting a proactive stance on your health trajectory. Not only does early detection empower individuals to implement timely interventions to mitigate the progression of disease, but preventative blood work also facilitates personalized healthcare, allowing for tailored interventions based on an individual's unique biomarker profile. By monitoring key markers such as cholesterol levels, blood sugar levels, inflammatory markers, etc, healthcare providers can not only patient's detect and manage chronic conditions like diabetes and heart disease but also proactively address risk factors for future health issues. Ultimately, preventative blood work fosters a culture of health and wellness by empowering individuals to take charge of their health, leading to improved health outcomes, enhanced quality of life, and an extended health span. Let's start approaching medicine as 'healthcare ', not 'sickcare '. To learn more about The Wellness Check , or preventative strategies to optimize your health span, contact Dr. Holmberg, ND at 647 351 7282, or visit us online .

If it’s been a few days since your last bowel movement, you’re probably getting a bit uncomfortable. How can you get things moving again without resorting to a dependency on medication?  Constipation, characterized by infrequent bowel movements or difficulty passing stool, is a common gastrointestinal complaint affecting people of all ages. While over-the-counter and prescription medications are often used to manage constipation, many individuals seek natural remedies to promote regularity and alleviate discomfort. From a medical standpoint, natural treatments can offer effective relief with fewer side effects. In this article, we'll explore several evidence-based natural treatments for constipation. Tips To Improve Constipation Naturally for Better Gut Health Few things are more frustrating than feeling the urge but being unable to go. Kick your digestive system into high gear with these  constipation relief  methods. Eat Plenty of Fibre Increasing dietary fibre intake is one of the most recommended strategies for relieving constipation. Fibre adds bulk to stool, making it easier to pass through the digestive tract. It also helps regulate bowel movements by promoting regularity. However, there are two kinds of fibre, and you may not know which one to choose. Soluble fibre softens stools and improves their consistency, while insoluble fibre bulks up stools and might help them pass through your gut more easily. You’ll find insoluble fibre in whole grains, vegetables, and wheat bran. Soluble fibre is found in vegetables, fruits, beans, lentils, nuts, seeds, and peas. Both types of fibre can relieve constipation, but non-fermentable water-soluble fibre (such as partially hydrolyzed guar gum or acacia gum) is typically best. That’s because insoluble fibre can worsen constipation in people with  irritable bowel syndrome (IBS)  and chronic idiopathic constipation. Load Up on Water When was the last time you grabbed a glass of water? If you don’t sip much H20 throughout the day, your lack of hydration could be causing constipation. According to experts, women should drink at least 2.7 L of water daily, while men should have at least 3.6 L daily. Adequate hydration is essential for maintaining healthy bowel function. Drinking plenty of water throughout the day softens stool, making it easier to pass. Dehydration is the most common contributor to constipation, so it's important to consume an adequate amount of fluids, particularly water. Aim to drink at least eight glasses of water daily, and limit the intake of caffeinated and alcoholic beverages, which can have a dehydrating effect. Exercise Regular physical activity promotes bowel motility and can help alleviate constipation. Exercise stimulates the muscles of the digestive tract, facilitating the movement of stool through the intestines. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. Activities such as walking, jogging, cycling, and swimming can all contribute to improved bowel function. Try a Probiotic Think of  probiotics  as microscopic good guys that can give your gut a helping hand. They play a crucial role in supporting digestive health and may help alleviate constipation through several mechanisms: 1. Regulation of Gut Microbiome: Probiotics help maintain a diverse and balanced population of bacteria in the gut. An imbalance in gut bacteria, known as dysbiosis, can contribute to digestive issues, including constipation. By restoring balance to the microbiome, probiotics promote optimal digestive function. 2. Enhanced Gut Motility: Probiotics may stimulate the muscles of the digestive tract, promoting bowel movements and improving gut motility. Certain strains of probiotics have been shown to increase the frequency and consistency of stools, making them easier to pass. 3. Production of Short-Chain Fatty Acids (SCFAs): Probiotics can ferment dietary fiber in the colon, leading to the production of short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate. SCFAs play a crucial role in maintaining gut health by nourishing the cells lining the colon, promoting water absorption, and enhancing bowel motility. 4. Regulation of Immune Function: The gut microbiome plays a key role in regulating immune function, and probiotics can modulate immune responses in the gastrointestinal tract. By promoting a healthy immune system, probiotics may help reduce inflammation and improve overall gut health, which can contribute to alleviating constipation. 5. Reduction of Intestinal Transit Time: Probiotics may help decrease the time it takes for food to pass through the digestive tract, reducing the risk of constipation. By enhancing intestinal transit time, probiotics promote more efficient digestion and elimination of waste. 6. Alleviation of Stress-Induced Constipation: Stress can disrupt gut function and contribute to constipation. Probiotics have been shown to have potential benefits for mental health, including reducing stress and anxiety. By supporting a healthy gut-brain axis, probiotics may help alleviate stress-induced constipation. These microorganisms colonize the intestines and support a healthy balance of bacteria in the gut microbiome. Probiotic-rich foods, such as yogurt, kefir, sauerkraut, and kimchi, can be incorporated into the diet to enhance digestive health. Additionally, probiotic supplements are available and may be beneficial for individuals experiencing chronic constipation (but not all probiotics are indicated here, so make sure to discuss the right strains with your Naturopathic Doctor ). Bowel Retraining When you do get the urge to go, don’t ignore it. Ignoring that urge has been shown to worsen constipation, and if the problem persists for too long, you might need medical help. Instead, give yourself a little extra time in the morning, allowing yourself to relax and go. Doing this will increase the likelihood of consistent bowel movements. I’ve tried all of this. What's next? If you’ve exhausted the prior solutions and they just don't seem to be working for you, it might be time to get some help. Common underlying causes of constipation, like SIBO, bacterial dysbiosis, thyroid disorders, intestinal permeation (leaky gut), or a complex motility disorder may be at the root of your issues, and additional testing may be required.  Naturopathic Care can help you investigate for these concerns, and get to the root cause of your constipation. To learn more about natural support for your digestion, or preventative strategies to optimize your gut health, contact Dr. Holmberg , Toronto Naturopathic Doctor at (647) 351-7282, or   visit us online   here.

In the world of healthcare, the shift from treating symptoms to identifying root causes has become increasingly prominent. Functional medicine is at the forefront of this evolution, offering a more in-depth approach to understanding and addressing certain health concerns that modern medicine is still lacking solutions for. One of the most valuable tools in this practice is the comprehensive stool test, a diagnostic powerhouse that delves into the intricate ecosystem of the gut. Unlike standard stool tests, which often focus on identifying pathogens or blood, functional medicine stool testing offers a detailed analysis of various markers, providing critical insights into overall health. What is Comprehensive Stool Testing? Functional medicine stool testing is a thorough evaluation of the gastrointestinal (GI) tract, assessing a wide array of biomarkers that reflect the health and function of the gut. These tests analyze the microbiome (the community of microorganisms living in the intestines), digestive function, and immune response, among other factors. The goal is not merely to identify the presence of disease but to understand the underlying factors that contribute to health imbalances. Key Markers Tested in Comprehensive Stool Analysis 1. Microbial Balance : Bacteria : This includes both beneficial and pathogenic bacteria. A balanced gut microbiome is essential for digestion, nutrient absorption, and immune function. Yeast and Fungi : Overgrowth of yeast, such as Candida, can lead to systemic issues like fatigue, brain fog, and digestive disturbances. Parasites : While rare, parasitic infections can cause significant GI symptoms and systemic health issues. 2. Digestive Function : Elastase-1 : This enzyme marker assesses pancreatic function, crucial for breaking down fats, proteins, and carbohydrates. Fecal Fat : Elevated levels of fecal fat can indicate malabsorption issues, often linked to pancreatic insufficiency or bile acid deficiency. Protein Breakdown Products : Incomplete digestion of proteins can result in inflammation and contribute to conditions like leaky gut syndrome. 3. Inflammation Markers : Calprotectin : A marker for inflammation, particularly in the intestines. Elevated levels may indicate inflammatory bowel disease (IBD) or o ther inflammatory conditions. Lactoferrin : Another inflammatory marker, often elevated in cases of bacterial infection or IBD. 4. Immune Function : Secretory IgA (sIgA) : This antibody plays a critical role in gut immunity. Low levels can indicate immune suppression, while high levels may suggest an active immune response to pathogens or food antigens. 5. Gut Permeability : Zonulin : This marker indicates the permeability of the gut lining. Elevated levels of zonulin are associated with " leaky gut syndrome ," a condition linked to autoimmune diseases, allergies, and systemic inflammation. What Can Comprehensive Stool Testing Diagnose? Functional medicine stool testing can uncover a variety of conditions and imbalances, including: Gut Dysbiosis : An imbalance in the gut microbiome, which can lead to symptoms like bloating, gas, and irregular bowel movements. Dysbiosis is also linked to systemic conditions like autoimmune diseases and mental health disorders. Inflammatory Bowel Disease (IBD) : Conditions like Crohn's disease and ulcerative colitis can be identified through elevated inflammatory markers. Irritable Bowel Syndrome (IBS) : While IBS is a functional disorder, stool testing can help identify contributing factors such as SIBO (small intestinal bacterial overgrowth) or food sensitivities. Pancreatic Insufficiency : Low elastase-1 levels can indicate pancreatic insufficiency, leading to malabsorption and nutrient deficiencies. Leaky Gut Syndrome : Elevated zonulin levels suggest increased gut permeability, which can contribute to autoimmune conditions and chronic inflammation. Why Comprehensive Stool Testing is Superior to Standard Stool Tests While standard stool tests are valuable for diagnosing acute infections or detecting blood in the stool, they fall short of providing a comprehensive picture of gut health. Functional medicine stool testing, on the other hand, offers a detailed analysis of multiple biomarkers, giving practitioners a holistic understanding of the patient's gastrointestinal and overall health. Here’s why it’s superior: Comprehensive Insight : Functional medicine stool tests provide a more detailed analysis of the gut microbiome, digestive enzymes, inflammation, and immune function, offering a broader perspective on gut health. Personalized Treatment Plans : The depth of information gained from these tests allows practitioners to tailor treatments specifically to the individual’s needs, addressing root causes rather than just symptoms. Preventative Health : By identifying imbalances before they become symptomatic, functional medicine stool testing can help prevent chronic diseases and maintain long-term health. Holistic Approach : Functional medicine stool testing aligns with the broader goals of functional medicine, which seeks to treat the whole person, not just isolated symptoms or conditions. Conclusion Functional medicine comprehensive stool testing is a powerful tool in the pursuit of optimal health. Assessing a wide range of biomarkers provides insights into the complex interactions within the gut, helping to identify the root causes of health issues and guiding personalized treatment plans. Whether you are dealing with chronic digestive issues, autoimmune conditions, or simply want to optimize your health, functional medicine stool testing offers a level of insight that standard stool tests cannot match. In a world where personalized, preventative care is becoming increasingly important, this type of testing is not just beneficial—it’s essential. To learn more about comprehensive stool testing, or preventative strategies to optimize your gut health,   contact Dr. Courtney Holmberg ,   Toronto Naturopathic Doctor  at (647) 351-7282.

In today’s fast-paced world, stress has become a common part of every day life. We're aware of its effect on our mental well-being, but it may have an every greater role on our physical health than some realize. One of the hormones at the center of our stress response is cortisol . Often called the "stress hormone," cortisol is essential for helping us respond to stress, but chronically high levels can contribute to a range of health issues, including weight gain. In this article, we’ll explore the correlation between cortisol and weight gain, how stress impacts our body, and ways to manage cortisol levels to maintain a healthy weight. What is Cortisol? Cortisol is a hormone produced by the adrenal glands, located on top of the kidneys. It plays several roles in the body: Regulates Metabolism : Cortisol helps to regulate the body's metabolism by influencing how carbohydrates, fats, and proteins are converted into energy. Manages Stress Response : It helps the body respond to stressful situations by releasing more glucose into the bloodstream to provide energy for a "fight or flight" response. Controls Inflammation : Cortisol has anti-inflammatory effects that help the immune system respond to injury and infection. While these functions are essential for short-term stress management, problems arise when cortisol levels remain elevated for extended periods due to chronic stress. The Link Between Cortisol and Weight Gain Cortisol and Fat Storage Cortisol has a direct influence on where the body stores fat. When cortisol levels are elevated, it signals the body to store energy in the form of fat—especially in the abdominal area. This type of fat, known as visceral fat, surrounds organs and has been linked to a higher risk of cardiovascular disease and type 2 diabetes. Increased Appetite and Cravings Chronic stress and high cortisol levels can increase appetite and cravings, particularly for high-calorie, sugary, and fatty foods. This craving is the body’s way of seeking a quick energy boost to prepare for a perceived threat. Unfortunately, if this response happens frequently, it can lead to overeating and weight gain. Slowed Metabolism While cortisol initially boosts energy, over time, consistently high cortisol levels can lead to a slower metabolism. This occurs because cortisol disrupts the balance of other hormones, such as thyroid hormones and insulin, which are essential for regulating metabolic rate and maintaining healthy body weight. Impact on Muscle Mass Cortisol can also break down muscle tissue to release amino acids for energy in times of stress. Since muscle tissue plays a key role in burning calories, loss of muscle can further decrease metabolism, making weight gain more likely. How Cortisol Impacts Insulin Resistance and Blood Sugar High cortisol levels cause a spike in blood sugar, which is helpful in acute stress scenarios but problematic if it becomes a chronic response. Repeated spikes in blood sugar can lead to insulin resistance—a condition where the body becomes less effective at using insulin to lower blood sugar. Insulin resistance not only increases the risk of diabetes but also contributes to weight gain, especially around the abdomen. Managing Cortisol for Healthy Weight Understanding the role of cortisol in weight gain is the first step in addressing the issue. Here are some practical ways to manage cortisol levels: Regular Exercise Physical activity can reduce cortisol levels over time, especially exercises like yoga, walking, pilates, hiking or swimming. While intense exercise might temporarily increase cortisol, regular moderate exercise helps regulate cortisol and reduce stress. Pro Tip: I've learnt from actively monitoring my heart rate (aka cortisol levels) is to exercise earlier in the day. This allows the cortisol from exercise to drop well before bedtime and not negatively impact your sleep. Mindfulness and Relaxation Techniques Meditation, deep breathing exercises (aka breathwork), and activities like journaling can significantly reduce stress and lower cortisol. These activities engage the parasympathetic nervous system, which calms the body and counteracts the effects of cortisol. Sleep Quality Poor sleep can lead to elevated cortisol levels and an increased risk of weight gain. Aim for 7-8 hours of quality sleep per night to help the body reset and manage stress effectively. Balanced Diet Eating a diet predominantly made of in whole foods, high fiber, and protein can help stabilize blood sugar levels, reducing cortisol fluctuations. Foods high in refined sugar and unhealthy fats can cause rapid spikes in blood sugar, leading to a secondary cortisol surge. Essentially, keep protein high and sugar low - its that simple. Limit Stimulants Caffeine and alcohol can elevate cortisol levels if consumed in excess. While small amounts might not harm, moderation is key, especially for individuals under chronic stress. Final Thoughts Understanding the relationship between cortisol and weight gain is essential in developing a holistic approach to managing stress and maintaining a healthy weight. While some cortisol is necessary for normal bodily functions, prolonged high levels can disrupt metabolism, increase appetite, and lead to fat accumulation. By making lifestyle changes like regular (but not excessive) exercise, balanced eating, and stress reduction techniques, you can help control cortisol levels and support your body’s natural balance. In a world that doesn’t often slow down, taking a proactive approach to managing stress can be one of the most powerful tools in maintaining both mental well-being and physical health. To explore in pacts of cortisol on your weight and metabolism (as well as look into cortisol testing), don’t hesitate to make an appointment with Toronto Naturopathic Doctor Dr. Courtney Holmberg by booking online here or reaching out for further assistance at 647 351 7282 (must be resident of Ontario).